As a recent breast cancer survivor, it is stunningly clear that I stand on the shoulders of fierce women. It was the year after I graduated from high school when Congress passed a bill called the Women’s Health and Cancer Rights Act of 1998, mandating that insurance companies cover breast reconstruction after a mastectomy for patients who choose to do so. Other women’s minds and bodies fought this fight, made a way.
Having adequate insurance and the ability to choose my medical oncologist and surgical team for the double mastectomy with reconstruction has made an enormous difference.
I recently met a woman with sparkly eyes and a warm laugh who hasn’t had access to care. She sighed and said, “tell me when it’s free and then I will get the mastectomy that I need.” And the disparities in healthcare for breast cancer (and so many other illnesses) extend beyond socioeconomics/class to include race/ethnic group, location/geographic region, age, sexual orientation, gender identity, and physical disability (Sighoko et al, 2018; Damaskos et al., 2018; Tabaac et al, 2018; Nandam, et al., 2018).
The healthcare “playing field” is uneven…
For example, African-American women in the US are over 40 percent more likely to die from breast cancer than Caucasian women (Sighoko et al., 2017). There are regions of the country where this disparity is even more pronounced. I’m undergoing treatment here in Nashville, and in the neighboring city of Memphis, TN, African-American women are twice as likely to die from breast cancer as Caucasian women” (Gold, 2015).
Ongoing fierce efforts toward change are essential. Life-saving healthcare must not be available for just some. While healthcare disparity is a layered issue (e.g., social and structural factors functioning at the local level—including such things as practitioner supply, public health infrastructure, racism and discrimination, insurance coverage, etc.), we can start by letting our policymakers know that we support health equity for all.
Damaskos, P., Amaya, B., Gordon, R., & Walters, C.B. (2018, January). Intersectionality and the LGBT Cancer Patient. In Seminars in oncology nursing. WB Saunders.
Gold, S.S. (2015, October). Why are so many Black women dying of breast cancer? O, The Oprah Magazine, Retrieved 4/15/18, From: http://www.oprah.com/health_wellness/breast-cancer-and-black-women
Nandam, N., Gaebler-Spira, D., Byrne, R., Wolfman, J., Reis, J. P., Hung, C. W., … & Marciniak, C. (2018). Breast cancer screening in women with cerebral palsy: Could care delivery be improved?. Disability and health journal.
Sighoko, D., Hunt, B. R., Irizarry, B., Watson, K., Ansell, D., & Murphy, A. M. (2018). Disparity in breast cancer mortality by age and geography in 10 racially diverse US cities. Cancer epidemiology, 53, 178-183.
Sighoko, D., Murphy, A. M., Irizarry, B., Rauscher, G., Ferrans, C., & Ansell, D. (2017). Changes in the racial disparity in breast cancer mortality in the ten US cities with the largest African American populations from 1999 to 2013: The reduction in breast cancer mortality disparity in Chicago. Cancer Causes & Control, 28(6), 563-568.
Tabaac, A. R., Sutter, M. E., Wall, C. S., & Baker, K. E. (2018). Gender Identity Disparities in Cancer Screening Behaviors. American journal of preventive medicine.